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Tym Rourke, Foundation director of substance use disorders grantmaking. (Photo by Cheryl Senter)

Tym Rourke, Foundation director of substance use disorders grantmaking. (Photo by Cheryl Senter)

The power of prevention

Some good news: Youth substance use is on the decline

We’ve grown accustomed to hearing consistently bad news about the state’s opioid epidemic.

But some data came across recently that made me cheer:

Substance use among youth in New Hampshire is on the decline.

The numbers show that prevention works.

High schools across New Hampshire participate in the Youth Risk Behavior Survey (YRBS) every two years. The survey, administered by the Centers for Disease Control and Prevention, measures attitudes and behaviors associated with substance misuse, mental health and other risk behaviors. The survey was administered in 2015 to 14,837 students in 67 public high schools across the state with the support of the New Hampshire Departments of Education and Health and Human Services.

The results, released in February, show the numbers going in the right direction.


As the chart indicates, regular (past 30-day) use of alcohol and rates of binge drinking have dropped significantly since 2005. Marijuana use is also down. And, very significantly, the data show a decline in the misuse of prescription drugs since 2011. Since misuse of prescription drugs frequently leads to heroin use, this decline represents an important step in turning the corner on our current opioid epidemic.

Preventing substance use disorders is a priority area for the New Hampshire Charitable Foundation, and one of the areas of focus of our “New Hampshire Tomorrow” agenda for increasing youth opportunity. Generous donors have made it possible for us to work with a comprehensive network of partners – as part of a statewide plan to address the disease of addiction – to implement proven prevention strategies, expand access to treatment and support recovery.

When the Foundation began its 10-year investment in prevention in 2011, we chose YRBS as the data by which we would measure progress toward our goal of contributing to a five percent reduction in youth substance use in New Hampshire by 2017. As these data show, that goal has been met or exceeded in all areas measured.

While it is difficult  to “prove” cause and effect based on any single strategy, there are takeaways from  the data that give us reason to celebrate.

The latest YRBS numbers demonstrate that prevention works. Significant investments by the Foundation and other public and private funders in evidence-based prevention strategies through the state’s Regional Public Health Networks and other partners are showing returns. Strong community coalitions across the state are working to provide education and support services for youth and families to minimize risk and intervene early to prevent problems associated with substance misuse. Pockets of innovation and effectiveness – like Youth Leadership Through Adventure, Media Power Youth and the Life of an Athlete program – are fast becoming part of the collective solution.

These data are not reason to let up – but reason to buckle down. They demonstrate that prevention of substance misuse, like other public health challenges, is long-term work that requires ongoing attention. And it’s not all great news: While youth binge drinking has indeed dropped since 2005, it remained level from 2013 to 2015. Lifetime rates of heroin use have remained flat – which means there is much more work to do. (YRBS does not track heroin use among high school students over the past 30 days, as with other substances reflected in the chart above, but only measures whether young people have ever used heroin. The data show no statistically significant change in lifetime rate of heroin use over the past five years.) And even though our overall rates of youth substance use are down, they still remain among the highest in the United States.

For the Foundation, the data reinforce the need to remain committed to supporting effective strategies for prevention of substance use among New Hampshire kids well into the future.

New Hampshire is in the middle of an opioid epidemic. Which means that a lot of focus – and appropriately so – is on needed expansions in treatment and recovery supports. But these data reinforce the fact that substance use disorders are preventable. We are making progress among a younger generation – and if we stick with them, we will help many of them avoid succumbing to the disease of addiction that now threatens so many individuals, families and communities across our state.

Read more about New Hampshire YRBS results and results as reported by public health region.

Tym Rourke is the Foundation’s Director of Substance Use Disorders Grantmaking and chair of the Governor’s Commission on Alcohol and Drug Abuse Prevention, Treatment, and Recovery.